摘要
【目的】探讨大柴胡汤加味方联合手术治疗急性化脓性阑尾炎的临床效果。【方法】采用回顾性研究方法,选取2020年6月至2021年6月在广州中医药大学第一附属医院胃肠甲状腺外科住院行腹腔镜下阑尾切除术并且术后病理确诊为急性化脓性阑尾炎的79例患者,根据术后是否服用大柴胡汤加味方分为观察组42例和对照组37例。对照组术后给予常规抗生素治疗以及适量的静脉营养支持,观察组在对照组的基础上自术后第1天开始给予大柴胡汤加味方口服治疗,疗程为3 d。观察2组患者术后恢复情况及治疗前后的体温、白细胞计数(WBC)、中性粒细胞百分比(NEU%)的变化情况。【结果】(1)观察组和对照组患者的手术时间分别为(61.07±13.98)min、(60.57±13.08)min,手术出血量分别为(5.05±1.71)m L、(5.03±1.52)m L,腹腔引流管留置率分别为47.62%(20/42)、54.05%(20/37),差异均无统计学意义(P>0.05)。(2)治疗后,2组患者体温、WBC、NEU%均较治疗前明显下降(P<0.01),且观察组对体温和WBC、NEU%的下降作用均明显优于对照组,差异均有统计学意义(P<0.05)。(3)观察组的术后首次排气时间、首次进食半流质食物时间以及术后住院时间均短于对照组,差异均有统计学意义(P<0.05)。(4)2组患者术后均无切口感染、腹腔感染、肠粘连、肠梗阻、粪瘘、腹腔脓肿包块形成等并发症发生。【结论】大柴胡汤加味方联合腹腔镜手术治疗急性化脓性阑尾炎具有良好疗效,能促进术后患者胃肠功能恢复,预防术后感染等并发症,缩短患者术后排气和住院时间。
Objective To investigate the clinical efficacy of modified Da Chaihu Decoction combined with surgery in the treatment of acute suppurative appendicitis.Methods Seventy-nine patients who underwent laparoscopic appendectomy(LA)and were confirmed as acute suppurative appendicitis by postoperative pathological examination in the department of gastrointestinal and thyroid surgery of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from June 2020 to June 2021,were included into the retrospective analysis.The patients were divided into the observation group(42 cases)and the control group(37 cases)according to the medication of modified Da Chaihu Decoction or not after surgery.The control group was given conventional antibiotic treatment and appropriate intravenous nutritional support after surgery,and the observation group was given oral administration of modified Da Chaihu Decoction from the first day after surgery.The course of treatment lasted for 3 days.Postoperative recovery and the body temperature,white blood cell(WBC)count and neutrophil percentage(NEU%)before and after treatment in the two groups were observed.Results(1)For the observation group and the control group,the operative time was(61.07±13.98)min and(60.57±13.08)min,the operative bleeding volume was(5.05±1.71)mL and(5.03±1.52)mL,and the rate for indwelling peritoneal cavity drainage tube was 47.62%(20/42)and 54.05%(20/37)respectively,the differences being not statistically significant(P>0.05).(2)After treatment,the body temperature,WBC count and NEU%of the two groups were significantly decreased compared with those before treatment(P<0.01),and the effect on decreasing body temperature,WBC and NEU%of the observation group was significantly superior to that of the control group,the difference being statistically significant(P<0.05).(3)In the observation group,the time for first postoperative anal exhaust,the time for first postoperative intake of semi-liquid food and the postoperative hospitalization time were shorter than those in the control group,the differences being statistically significant(P<0.05).(4)No postoperative complications such as surgical incision infection,peritoneal cavity infection,intestinal adhesion,intestinal obstruction,fecal fistula,and abscess and mass formation in the peritoneal cavity occurred in both groups.Conclusion The combination of modified Da Chaihu Decoction and laparoscopic surgery for the treatment of acute suppurative appendicitis exerts good efficacy in promoting the recovery of postoperative gastrointestinal function,preventing postoperative complications such as infection,and shortening the time for postoperative anal exhaust and hospitalization time for the patients.
作者
周淑怡
黎颖娴
卢蔚起
赵先明
ZHOU Shu-Yi;LI Ying-Xian;LU Wei-Qi;ZHAO Xian-Ming(The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2022年第5期1045-1049,共5页
Journal of Guangzhou University of Traditional Chinese Medicine
关键词
急性化脓性阑尾炎
大柴胡汤加味方
腹腔镜下阑尾切除术
术后首次排气时间
术后住院时间
白细胞计数
acute suppurative appendicitis
modified Da Chaihu Decoction
laparoscopic appendectomy
timefor first postoperative anal exhaust
postoperative hospitalization time
white blood cell count
作者简介
周淑怡(1995-),女,硕士研究生,E-mail:20192109606@stu.gzucm.cn;通信作者:赵先明,男,教授、主任医师,硕士研究生导师,E-mail:13682229138@163.com
